King's College Hospital NHS Foundation Trust is one of the UK's largest and busiest teaching Trusts with a turnover of c£1.7 billion, 1.5 million patient contacts a year and more than 15,000 staff based across 5 main sites in South East London. The Trust provides a full range of local hospital services across its different sites, and specialist services from King's College Hospital (KCH) sites at Denmark Hill in Camberwell and at the Princess Royal University Hospital (PRUH) site in the London Borough of Bromley.
Job overview
The post holder must be an experienced registered professional, with the required skills and experience as noted in this job description and must be registered with the NMC, HCPC, or GPhC. Practicing as a trainee (Band 7) under direct supervision or qualified autonomous Advanced Clinical Practitioner (Band 8a), the postholder will undertake comprehensive specialist holistic assessments for individuals presenting with frailty within the acute care setting, with the purpose of creating an individualised agreed management plan; incorporating pharmacological considerations, long-term conditions management, frailty syndrome identification, prevention and management, diagnostic reasoning and initiating onward referral to specialist teams as appropriate in the Acute Frailty Assessment Unit and other areas of the hospital including the urgent and emergency care (UEC) areas such as the Emergency Department.
Postholder will need to complete the Trust and / or speciality advanced practice competency framework along with the academic requirements to work at an advanced practice level as an independent practitioner to be banded as an 8a. Minimum weekly hours for those in a trainee position to undertake educational Master's in Advanced Practice is 30 hours.
Main duties of the job
The Acute Frailty Assessment multi-disciplinary team (MDT) provides a responsive, safe effective caring service that is well led and is commissioned to reflect the needs of the local community. Providing expert, high-quality patient-centred care which encompasses evidence-based assessment, examination, diagnosis, treatment and management plan within an agreed scope of practice throughout the Adult Medicine Care group in line with their relevant code of professional practice.
The post holder will spend a minimum of 90% of their time in direct autonomous clinical practice, providing specialist clinical advice, leadership and support. Ensuring the needs of the service are met through exercising and demonstrating high levels of clinical judgement, critical analysis and advanced decision-making skills. To lead as a driver for change, to monitor and improve standards through supervision, evidence-based practice, clinical audit, research and education.
Clinical Responsibilities:
1. To deliver, participate and lead clinical care of patients.
2. To appropriately assess, examine, investigate, diagnose and treat patients, resulting in the safe management and appropriate referral or discharge of patients with undifferentiated and undiagnosed presentations.
3. To be responsible and accountable for own decisions, actions and omissions at this level of practice, demonstrating a critical understanding of own level of responsibility and autonomy and the limits of own competence and professional scope of practice.
4. Order and interpret investigations, such as but not exclusively: laboratory tests and x-rays; and act on results as appropriate.
5. Initiate drug therapy/medication within the parameters of agreed clinical guidelines and in accordance with present legislation supply and prescribing of medicines.
6. Demonstrate a high level of knowledge in relation to pattern of disease or disorder, markers of condition progression and range of treatment available at each stage of disorder or condition.
7. Be able to assess critically and re-evaluate the clinical situation as the patient's condition changes.
8. To be responsible for the delivery of a detailed, accurate and potentially complex clinical handover and to produce detailed and accurate written information within the medical notes regarding all clinical assessments, investigations completed and requested, and treatments administered.
9. To advise, communicate and work in conjunction with the wider MDT, leading and facilitating a patient or client focused, co-ordinated case management approach across primary and secondary care for people who are most vulnerable to, and at high risk of repeat admissions to hospital.
10. To improve the quality of the patient experience by identifying and meeting the individual clinical needs of patients whilst empowering the MDT to do the same.
11. Ability to adapt specialist clinical knowledge and skills to different clinical settings and influence efforts across health and social services to shape multi-disciplinary pathways designed to support patient choice, improve quality of life, promote self-management and assure early intervention through the proactive provision of care in or as close to the patient's own home as possible.
12. To always act as an advocate for individuals presenting with frailty, their carers and relatives.
13. Utilise and demonstrate sensitive communication styles, to ensure patients are fully informed and consent to treatment.
14. Collect, collate, evaluate and report information, maintaining accurate confidential patient records to a high standard reflective of Advanced Clinical Practice.
15. Support the development, implementation and audit of protocols, guidelines and policies for the Acute Frailty Service.
16. Establish and maintain a regional and national network of contacts relevant to the service.
Leadership/Managerial Responsibilities:
1. Act always with Compassion and in lines with Kings Values, and be committed to delivering high quality care, using effective communication, clinical competence and courage when needed.
2. Participate in the recruitment, selection and retention of staff.
3. To develop own leadership skills within the Advanced Clinical Practitioner Team.
4. Review the effectiveness of clinical care provided ensuring that patient safety is maintained, and care delivery meets the standards required by the Trust and the Care Quality Commission.
5. Manage change through strategic thinking, use of negotiating skills, self-awareness and effective communication.
6. Undertake clinical supervision and systematic peer caseload review of colleagues on an individual or group basis.
7. Assess and monitor risk in own and others' practice, acting on results, thereby ensuring safe delivery of care.
8. Work collaboratively with representatives of other clinical areas, disciplines and services to provide a seamless pathway of care.
9. Lead and contribute to investigation of incidents and complaints when required; participate in identifying lessons learnt and the sharing of learning across the organisation.
10. Continually monitor standards of care through quality markers, achievement of Trust targets, and benchmarking.
11. To be conversant with all Trust policies and procedures and ensure they are correctly implemented.
12. Always adhere to confidentiality with sensitive personal data.
13. Prioritise, organise and manage own workload in a manner that maintains and promotes quality.
Person specification
Qualifications and registration
Essential criteria
* Registered Nurse / Allied Healthcare Professional (AHP) / Pharmacist
* Holds a BSc or a minimum of 90 credits at Level 6 education
* ILS or ALS
Desirable criteria
* Master's / DiP in advanced Practice or Master's level award that covers all 4 pillars of the Advanced Clinical Practice (ACP) capabilities (essential to include advanced clinical assessment skills and diagnostic reasoning qualifications)
Experience
Essential criteria
* Significant post registration experience (minimum of 5 years, per RCEM for Band 7, or 7 years for Band 8a))
* Evidence of involvement in the development of programmes of care, protocols and audits
* Demonstrate knowledge of legislation relevant to area of clinical practice
Desirable criteria
* Experience of developing specialist programmes of care for an individual or groups of patients / clients and of providing highly specialist advice
* Evidence of involvement in successful change management
* Experience of policy and protocol development and production
Skills
Essential criteria
* Advanced clinical assessment and documentation skills
* Autonomous clinical assessment skills
* Evidence of proactive involvement in the supervision and development of members of the multi-disciplinary team and able to demonstrate changes of practice through these
Desirable criteria
* Evidence of research involvement
IMPORTANT
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